What are the findings from the chest X ray and CT scan report?

Posted on Tue, 21 Jan 2014 in Lung and Chest disorders
Question: Hi. I had a chest xray while in the hospital for some back of head headache issues. The xray came back "hyperaerated lungs with mild increased interstitial markings." I never did find out reason for headaches. Then two weeks later an unenhanced CT scan was done. Here are the findings: "No evidence of pulmonary nodule, infiltrate or consolidation. There is no evidence of mediastinal adenopathy or pulmonary mass. Focal calcified mediastinal lymph nodes." So I am worried about the last part of that! I understand calcified can mean old infection but I looked up the various causes, like TB or sarcoidosis and fungal infections or histoplasmosis and never had any of those! WHat does "Focal" mean also? And, what about the interstital markings on the chest X-ray? Would they have shown up on the CT scan wondering why they were not addressed. For reference I am 45 yrs old nonsmoker (but grew up on in a smoking house). I am very athletic and do not seem to have any breathing problems. Please advise.
Answered by Dr. Shashi Dangwal 1 hour later
Brief Answer: Yes, it may indicate infection or sarcoidosis. Detailed Answer: Hello Dear, Thanks for posting your query on XXXXXXX The findings mentioned in the chest x ray are not present in the CT chest. But the findings mentioned in the CT chest do not give a clear picture and are a little confusing. On the one hand it says-no mediastinal lymphadenopathy and at the same time it says - focal mediastinal lymph nodes. Focal means-localized to one particular area. Yes, you are right-calcified lymph nodes may be seen in infections like TB, histoplasmosis or it may be present in sarcoidosis and in some other conditions. In my opinion, since you have no symptoms and are in good health, you need not worry. But if you are really worried you may get a HRCT chest done as it shows lung parenchyma better. You may also get a USG abdomen done to rule out lymph nodes in any other part of body. I suggest you consult a pulmonologist in your area who can have a complete look at you and advise you accordingly.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shashi Dangwal 30 minutes later
Hi. Thanks. I have a follow up question. The findings say no adeopathy but focal calcified lymph nodes. My understanding was that there was no lympadenopathy meaning they were not swollen, however they were calcified. Is that the inconsistency you were referring to- can't a lymph node be calcified but not swollen? Would I have known if I had one of those infections or was it possible I never knew it? Finally, I also had a pelvic/abdomen CT done and it was normal. Sorry, one more question. If I read the CT correct, there is no sign of interstitial lung disease, correct? Right, the only finding was the focal lymph node calcification? Would the CT scan have show any COPD or any other type of lung disease?
Answered by Dr. Shashi Dangwal 13 hours later
Brief Answer: Any enlargement of lymph nodes is called adenopath Detailed Answer: Any enlargement of lymph nodes is called adenopathy. Yes, probably your radiologist means that it is a calcified lymph node which is not enlarged. A calcified lymph node often means a healed lesion. Yes, it is possible that you had the infection without your knowledge and because of good immunity, it got healed by itself. Though TB is not so common in developed countries but histoplasmosis is known there. A calcified lymph node may also indicate sarcoidosis-a type of interstitial lung disease beside some more conditions. In sarcoidosis, you may have only lymph node enlargement which may or may not be calcified and no interstitial findings at the time of presentation. Yes, generally based on chest xray and CT findings it is possible to tell about COPD. I am of the opinion that in your case, since you have no symptoms and it`s only an accidental finding, nothing more needs to be done. In any case even if a diagnosis of sarcoidosis is arrived at, no treatment is required at present as you are asymptomatic. However, as said before, you may consult a local pulmonologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Shashi Dangwal


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